Select if you experience any of the following symptoms:

Dryness, Grittiness, or Scratchiness

Soreness or Irritation

Burning or Watering

Eye Fatigue

Frequency Rating

Never

Sometimes

Often

Constant

Frequency Rating

Never

Sometimes

Often

Constant

Frequency Rating

Never

Sometimes

Often

Constant

Frequency Rating

Never

Sometimes

Often

Constant

Severity Rating

No Problems

Tolerable – not perfect, but not uncomfortable

Uncomfortable – irritating but does not interfere with my day

Bothersome – irritating and interferes with my day

Intolerable – unable to perform daily tasks

Severity Rating

No Problems

Tolerable – not perfect, but not uncomfortable

Uncomfortable – irritating but does not interfere with my day

Bothersome – irritating and interferes with my day

Intolerable – unable to perform daily tasks

Severity Rating

No Problems

Tolerable – not perfect, but not uncomfortable

Uncomfortable – irritating but does not interfere with my day

Bothersome – irritating and interferes with my day

Intolerable – unable to perform daily tasks

Severity Rating

No Problems

Tolerable – not perfect, but not uncomfortable

Uncomfortable – irritating but does not interfere with my day

Bothersome – irritating and interferes with my day

Intolerable – unable to perform daily tasks

Score

Recommendation High

Recommend dry eye testing.

Recommendation Low

Mild symptoms. Encourage discussion at next comprehensive eye exam.

Dry Eye Quiz

Thomas Eye Center